Every minute of every day, a woman somewhere in the world dies of complications related to what should be the most life-affirming act: giving birth. The most common causes are uncontrolled bleeding, infection and obstructed birth. And for every woman who dies, it is estimated that another 30 become sick or are injured. In fact, childbirth is the leading cause of death and disability for women of reproductive age--more dangerous than heart disease and AIDS. And children left behind are the secondary victims. They're more likely to die because they are motherless.
These statistics are not new. In a recent NEWSWEEK cover package ("181 Things You Need to Know Now") Barbara wrote one of the essays, which talked about the shockingly high rate of deaths related to pregnancy and childbirth not only in developing countries but also in the United States. What makes these numbers particularly appalling--and worth revisiting--are that modern medicine has the tools to make childbirth safe for virtually all women. It begins with education; women need to understand the trouble signs in pregnancy. Access to skilled care is also vital. In so many parts of the world (and even in poor areas of this country), pregnant women do not get the help they need. Poverty is often the reason but there are other causes as well, including some things you may not think of such as war and political upheaval.
Even in the U.S., there are great disparities. The maternal mortality rate among black women is more than four times the rate among non-Hispanic white women, and black women are increasingly at higher risk of delivering prematurely and having low birth weight babies. Among American women, the most common complication of pregnancy is eclampsia, a condition that causes seizures. Women are at higher risk if they are obese, diabetic or have a history of high blood pressure.
Finding new ways to bridge the gap between knowledge and practice will be the theme of a major international health conference to be held in London in October. It's called Women Deliver and we'll be bringing you a report from the session in a future column. Conferences like Women Deliver help by getting the message out and bringing together policymakers, but there's a lot you can do if you're as concerned about this issue as we are. Here are some suggestions we've gathered from advocates for women's health at the United Nations Population Fund, Family Care International and the Center for Reproductive Rights, among others:
1. Tell policymakers that women count. It's hard to solve a problem unless you can clearly define it. In many countries, including this one, statistics about maternal death and disability are often estimates because accurate numbers simply aren't available. For example, if a woman dies of excessive bleeding after giving birth, her cause of death may be listed as hemorrhaging and the connection to childbirth may not be noted. Improving data collection is a critical step in improving services.
2. Educate yourself. If you're pregnant, learn what you need to do to have a healthy pregnancy. That means understanding the importance of warning signs such as abdominal pain or bleeding. This comprehensive site from the National Institutes of Health is a good place to start.
3. Help educate other women. Look for women's health groups in your community that provide resources for pregnant women and back them by volunteering or contributing money. Some national organizations also focus on specific dangers during pregnancy. These include the Preeclampsia Foundation, the National High Risk Pregnancy Support Network, the HELLP Syndrome Society, and the March of Dimes.
4. Fight domestic violence. Pregnant women are at high risk for abuse. Support local domestic violence initiatives or volunteer at domestic violence shelters. To learn more, see this site from the NIH.
5. Go beyond borders. Learn what's happening to women in the rest of the world. Start with these sites: the United Nations Population Fund, the World Health Organization and Family Care International. If you want to help, the White Ribbon Alliance has a list of things you can do. To find out more about the situation in one African country, you can check out this report on Kenyan women from the Center for Reproductive Rights and the Federation of Women Lawyers.
6. Reach out to women in trouble. One of the most devastating complications of childbirth is obstetric fistula, a rupture usually caused by obstructed labor, unsafe abortion or female genital cutting (a traditional practice in some cultures). Often, the result is uncontrolled leakage of feces or urine and consequently, social ostracism. This is a problem that could be eliminated with good obstetric care. To learn more, see One by One, or the Campaign to End Fistula.
7. Become an advocate. Make sure health care for women and children is on the agenda in the presidential campaign by writing your representatives in Congress and attending town-hall meetings during the primary season. Write letters to the editor of your local newspaper asking for more coverage of maternal health issues in this country and around the world. With that kind of pressure, you can help millions of women around the world whose stories need to be told.